An analysis of factors related to disability-free life expectancy at 65 years of age across Japanese prefectures in 2010

Yuka Sugawara Minagawa, Sophia University
Yasuhiko Saito, Nihon University

Background: A great deal of research deals with the relationships between macro-level socioeconomic indicators and health expectancy measures across the world. Relatively little is known, however, about factors associated with the health expectancy of the Japanese population. Design and Methods: We estimated disability-free life expectancy (DFLE) at 65 years of age by gender and prefecture using the Sullivan method. Data on disability prevalence are drawn from the Comprehensive Survey of Living Conditions of the People on Health and Welfare of 2010. Regression analyses are performed to investigate the association of DFLE at 65 with variables representing a prefecture’s wealth, labor, and welfare characteristics. Results: Our results show close relationships between socioeconomic factors and prefecture-level DFLE at 65. Income per capita, the proportion of workers older than 65, and welfare expenditures are positively related to DFLE at 65, whereas unemployment and Long-Term Care Insurance (LTCI) expenditures are inversely associated with DFLE at 65 for both genders, controlling for the rate of the elderly population. The proportion of the elderly relying on public assistance is related only to women’s DFLE. Conclusions: The present study provides strong evidence suggesting that a prefecture’s wealth, labor, and welfare conditions are related to the well-being of Japanese elders. Our findings suggest that narrowing socioeconomic disparities contributes to the health status of the Japanese population. Reducing regional health disparities therefore requires policy makers to take into account the socioeconomic conditions of each prefecture.